Recommendations for Effective Implementation of Telehealth for Diabetes Care

Telehealth appointment
Doctor has distance video call with patient during social distancing.
Experts provide recommendations for effective implementation of telehealth for diabetes care, with a focus on patient-to-clinic video encounters.

Diabetes technology has gained significant popularity in recent years, including the use of continuous glucose monitoring devices, easier data extraction from insulin pumps and Bluetooth glucose meters, and videoconferencing on available platforms. These improvements provide more opportunities and incentive to take advantage of telehealth in the management of diabetes.

Despite significant progress in the area of diabetes technology, telehealth is not widely used. In a review article published in Diabetes Technology & Therapeutics, experts provided recommendations for effective implementation of telehealth for diabetes care.

With a focus on patient-to-clinic video encounters, the review authors’ recommendations for diabetes telehealth programs were divided into 3 categories: technologic requirements, clinical operations, and maximizing benefit.

The experts recommended investment in basic hardware, including a widescreen monitor and quality headphones/microphones, and to ensure optimal lighting and appropriate room setup. With regard to video software, they explained that there are numerous options, some of which can be integrated with electronic health records (EHRs). As for diabetes care software, the choice should be based on the personal preference of the user and the key features for both the provider and patient.

Clinical operations recommendations included scheduling telehealth visits separately from in-person visits in schedules and having a set plan to follow if preceding in-person visits run late. The review authors also recommended developing standardized processes for previsit and postvisit tasks for telehealth patients, such as uploading data and scheduling follow-up, and to train staff and patients in these processes. It is important to review telehealth reimbursement codes and policies and how they may apply in each specific practice. In addition, EHR integration can be valuable; the authors recommended working with the EHR team to optimize tools for telehealth billing, documentation, and data capture.

As for maximizing benefit, the review authors suggested telehealth can be used to promote patient-driven and patient-centered diabetes care, but it is also important to guide patients’ expectations about billing, timing and frequency of video visits, and appropriate use of telehealth technology. Furthermore, it is critical to engage all institutional stakeholders early in the process to allow for effective integration of telehealth into routine clinical care.

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It is important to note that the review authors’ article was written prior to the coronavirus disease 2019 (COVID-19) pandemic and therefore does not include information about new or temporary telehealth policy changes.

“New telehealth technologies provide us with the means to extend traditional care in new ways, to improve its patient-centeredness, and to advance the health of populations through novel telehealth-driven care techniques. Appropriate use of these technologies requires sound clinical judgment, thoughtful implementation, and rigorous evaluation,” concluded the experts.

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Crossen S, Raymond J, Neinstein A. Top 10 tips for successfully implementing a diabetes telehealth program [published online April 21, 2020]. Diabetes Technol Ther. doi:10.1089/dia.2020.0042